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The aim of this study is to create an overview of the current literature and discuss the controversies within the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus. A search string was built in PubMed. The search was commenced on August 25, 2021 and closed on October 27, 2021. Two authors screened the studies in Covidence for inclusion according to the eligibility criteria in the protocol. The data were extracted from the studies and are reported in both text and tables. This review included 114 papers, of which 15 were randomized controlled trials (RCTs). The effect of LASER as a vaginal treatment was investigated for genitourinary syndrome of menopause in 36 studies (six RCTs), vulvovaginal atrophy in 34 studies (four RCTs) and urinary incontinence in 30 studies (two RCTs). Ten studies (three RCTs) investigated the effect of vulvar treatment for lichen sclerosus. Half of the included RCTs, irrespective of indication, did not find a significant difference in improvement in women treated with vaginal CO\n                    <jats:sub>2<\/jats:sub>\n                    or Er:YAG LASER compared with their respective controls. However, most non\u2010comparative studies reported significant improvement after exposure to vaginal or vulvar LASER across all indications. Included studies generally had a short follow\u2010up period and only a single RCT followed their participants for more than 6\u2009months post treatment. Adverse events were reported as mild and transient and 99 studies including 51\u2009094 patients provided information of no serious adverse events. In conclusion, this review found that the effect of vaginal and vulvar LASER decreases with higher study quality where potential biases have been eliminated. We therefore stress that all patients who are treated with vaginal or vulvar LASER should be carefully monitored and that LASER for those indications as a treatment should be kept on a research level until further high\u2010quality evidence is available.\n                  <\/jats:p>","DOI":"10.1111\/aogs.14353","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:12:11Z","timestamp":1651191131000},"page":"657-692","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["The evidence behind the use of\n                    <scp>LASER<\/scp>\n                    for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state\u2010of\u2010the\u2010art review"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2511-2837","authenticated-orcid":false,"given":"Olivia Engholt","family":"Mortensen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nordsj\u00e6llands Hospital, Institute of Clinical Medicine University of Copenhagen  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-2142","authenticated-orcid":false,"given":"Sarah Emilie","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nordsj\u00e6llands Hospital, Institute of Clinical Medicine University of Copenhagen  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-5663","authenticated-orcid":false,"given":"Ellen","family":"L\u00f8kkegaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nordsj\u00e6llands Hospital, Institute of Clinical Medicine University of Copenhagen  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2011.647840"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.14809"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","unstructured":"JinJ.Vaginal and Urinary Symptoms of Menopause. 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